Healthcare Provider Details

I. General information

NPI: 1598295420
Provider Name (Legal Business Name): SHANDY ABERG LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2017
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 S 4TH ST
MILES CITY MT
59301-4175
US

IV. Provider business mailing address

305 S 4TH ST
MILES CITY MT
59301-4175
US

V. Phone/Fax

Practice location:
  • Phone: 406-874-8700
  • Fax:
Mailing address:
  • Phone: 406-874-8700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberBBH-LCPC-LIC-24385
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: